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Controversies on lung cancers manifesting as part-solid nodules.

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Title:	Controversies on lung cancers manifesting as part-solid nodules.
Authors:	Yip, Rowena¹, Li, Kunwei^1,2, Liu, Li^1,3, Xu, Dongming¹, Tam, Kathleen¹, Yankelevitz, David F.¹, Taioli, Emanuela⁴, Becker, Betsy⁵, Henschke, Claudia I.¹ Claudia.Henschke@mountsinai.org
Source:	European Radiology. Feb2018, Vol. 28 Issue 2, p747-759. 13p. 1 Diagram, 3 Charts.
Subjects:	Lung cancer, Progression-free survival, Adenocarcinoma, Carcinogens, Oncology, Computed tomography, Lung tumors, Prognosis, Research funding, Retrospective studies
Abstract:	Purpose: Summarise survival of patients with resected lung cancers manifesting as part-solid nodules (PSNs).Methods: PubMed/MEDLINE and EMBASE databases were searched for all studies/clinical trials on CT-detected lung cancer in English before 21 December 2015 to identify surgically resected lung cancers manifesting as PSNs. Outcome measures were lung cancer-specific survival (LCS), overall survival (OS), or disease-free survival (DFS). All PSNs were classified by the percentage of solid component to the entire nodule diameter into category PSNs <80% or category PSNs ≥80%.Results: Twenty studies reported on PSNs <80%: 7 reported DFS and 2 OS of 100%, 6 DFS 96.3-98.7%, and 11 OS 94.7-98.9% (median DFS 100% and OS 97.5%). Twenty-seven studies reported on PSNs ≥80%: 1 DFS and 2 OS of 100%, 19 DFS 48.0%-98.0% (median 82.6%), and 16 reported OS 43.0%-98.0% (median DFS 82.6%, OS 85.5%). Both DFS and OS were always higher for PSNs <80%.Conclusion: A clear definition of the upper limit of solid component of a PSN is needed to avoid misclassification because cell-types and outcomes are different for PSN and solid nodules. The workup should be based on the size of the solid component.Key Points: • Lung cancers manifesting as PSNs are slow growing with high cure rates. • Upper limits of the solid component are important for correct interpretation. • Consensus definition is important for the management of PSNs. • Median disease-free-survival (DFS) increased with decreasing size of the nodule. [ABSTRACT FROM AUTHOR]
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Database:	Engineering Source
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Abstract:	<bold>Purpose: </bold>Summarise survival of patients with resected lung cancers manifesting as part-solid nodules (PSNs).<bold>Methods: </bold>PubMed/MEDLINE and EMBASE databases were searched for all studies/clinical trials on CT-detected lung cancer in English before 21 December 2015 to identify surgically resected lung cancers manifesting as PSNs. Outcome measures were lung cancer-specific survival (LCS), overall survival (OS), or disease-free survival (DFS). All PSNs were classified by the percentage of solid component to the entire nodule diameter into category PSNs <80% or category PSNs ≥80%.<bold>Results: </bold>Twenty studies reported on PSNs <80%: 7 reported DFS and 2 OS of 100%, 6 DFS 96.3-98.7%, and 11 OS 94.7-98.9% (median DFS 100% and OS 97.5%). Twenty-seven studies reported on PSNs ≥80%: 1 DFS and 2 OS of 100%, 19 DFS 48.0%-98.0% (median 82.6%), and 16 reported OS 43.0%-98.0% (median DFS 82.6%, OS 85.5%). Both DFS and OS were always higher for PSNs <80%.<bold>Conclusion: </bold>A clear definition of the upper limit of solid component of a PSN is needed to avoid misclassification because cell-types and outcomes are different for PSN and solid nodules. The workup should be based on the size of the solid component.<bold>Key Points: </bold>• Lung cancers manifesting as PSNs are slow growing with high cure rates. • Upper limits of the solid component are important for correct interpretation. • Consensus definition is important for the management of PSNs. • Median disease-free-survival (DFS) increased with decreasing size of the nodule. [ABSTRACT FROM AUTHOR]
ISSN:	09387994
DOI:	10.1007/s00330-017-4975-9